'Patient First' Requires Safe Staffing

The Saskatchewan government is setting our public health care system up for a fall.

The privatization of services such as MRIs, surgeries, and laundry has resulted in the disruption of public health care services, reduced access to sanitary laundry and linens in health care facilities, fewer good jobs in many Saskatchewan communities, and profits leaving our province. Other programs have recently been cut including the audiology program leaving those who are hearing impaired without necessary public health care resources.

SEIU-West health care providers see the lack of provincial government funding in our public health care system deteriorating the quality that is expected by the public.

As staff layoffs and funding cutbacks occur, health care providers in all areas experience higher workload burdens as they are left to pick up the pieces of a system in critical disarray. We know that every health care provider is an essential piece of our health care team. Yet, critical retention and recruitment issues have grown.

This, in combination with chronic understaffing within Saskatchewan’s Health Care system, is creating unsafe care environments resulting in injury or worse to the patients, residents, and staff.

The Ombudsman report in 2015 responded to the growing public criticism about staffing levels in long term care; the bottom line is that the motto “patient and family first” is just words, not action.

Front line health care providers have crushing workloads and decreased support; all in the name of cost savings. With the government’s proposed wage and benefit rollbacks to health care providers, this situation will only get worse.

It is time for our government to invest adequate funding to support mandatory minimum staff to patient ratios to prevent mistakes, compromised care and tragedies from happening in the health care sector.

SEIU-West health care providers want to deliver improved, quality patient first care. But how can health care workers provide service that puts patients first when our provincial government continues to put health care workers last?

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You can add any other concerns or personal stories you might have about the issue of unsafe staffing levels and ongoing cuts in health care. Here are some examples of issues being faced in health care across the province:

Acute Care:

Nursing staff (both CCAs & LPNs) are plagued with the following issues on a daily basis: working short, skipping rest periods, limited access to clean laundry & linens, non-replacement of support staff such as Unit Assistants and a mountain of overtime. In some circumstances, there are increased workloads due to issues such as prolonged (in some units upwards of two years) precautions for VRE: what this means is that all patients in the unit require a bath each day and all rooms must be wiped down each day. Often this requirement is added to the workload but there is no added staffing.

Home Care:

Nursing staff (both CCAs & LPNs) are required to cover for absent staff due to a non-replacement policy in the home care setting. How this occurs is most troublesome, as home care clients are often slotted into the schedule of another CCA or LPN on the day of the service being required. The health care provider gets more added work but no added time to complete it. Home care services are allotted to clients in time slots of 15 minutes or 30 minutes routinely so it is extremely difficult to add in more clients to a schedule when it is already full. Can you imagine how your client feels when they only see you for a 15 minute time slot and you say that you have to rush and leave early because you have added clients in your schedule? This increases the stress immensely.

Laundry Services:

Since the government contracted out laundry and linen services to the Alberta company, K-Bro Linen Systems, the quantity and cleanliness of linens has been inconsistent and unreliable. Stained bedding is not conducive to infection control in a hospital. Not having enough towels and pads for residents in long-term care facilities is shameful. Quality control and access remain important to the health care providers who want to put the needs of patients and residents first.

Long Term Care:

Example #1: One of the most compelling issues for care providers occurs when they cannot be present to address many of the needs of a palliative care resident who is in the end of life stage. Things like repositioning, skin lotion, mouth care, checking for skin breakdown, ensuring that the resident receives a sheepskin blanket to help with comfort; care providers just don’t have the time to do all of these things on day or evening shifts.

Example #2: Working short does not change care providers’ expected duties and responsibilities. When these duties simply cannot be accomplished, they are often told by management to ‘leave the resident in bed for the day’ or ‘do not bath this resident today’. This is not the fault of the understaffed and overworked caregivers; there is simply not enough support to ensure that each resident is getting the care they deserve.

Maintenance:

One of the most troubling issues for maintenance and facility services is that the cost of doing regular preventative maintenance has been a real stumbling block for our members to move forward in getting this done. There is a growing concern about unsafe circumstances arising due to the hazards created in facilities when preventative maintenance procedures continue to be delayed over budget years.

Technologies:

Example #1: Since the closure of the Canadian Blood Services testing facility in Regina, the workload for Laboratory Technologists in hospital transfusion departments has increased significantly. If someone is bleeding on an operating table, Lab Techs work to ensure the patient gets the right blood products so surgeons can save their lives. Yet they work short on a daily basis often working with half or less of the staff they are supposed to have on shift.

Example #2: These important health care professionals provide information for about 80% of the medical decisions that are made. In the last two years, many have been mandated to work overtime on a regular basis, others have been required to work short. Much of this is due to ongoing, prolonged retention and recruitment challenges that have not been addressed over time – this includes those who work in: cardiology & cardiovascular technologies, cytogenics, nuclear medicine, diagnostic sonography, medical laboratories, medical radiation technologies and others.

Example #3: Cuts to provincial services like the sale of STC, have impacted the ability to get blood products and other samples shipped from rural sites to test facilities in the city. Not only does it cost more to ship the samples, it also creates an uncertainty as to whether these biologically sensitive materials will show up on time for testing. This increases time pressures on staff to get tests done. When prenatal screening is added in the next year, they will need more staff to accomplish these important tests.

Example #4: In rural Saskatchewan, we have a number of facilities where there is only one full-time CLXT who is often required to work alone. On call (standby) requirements are rigorous and over time become a real health hazard. We have received reports (workload tracking forms) from our members indicating that the CLXT has been working alone - one instance there were 5 patients sent STAT from the community clinic for one CLXT to manage. The added stress and fatigue upon our members who work in diagnostics is worrisome for the health care team and their patients.